THEICHD-IIR1_short-form_ by peirongw

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									INTERNATIONAL HEADACHE SOCIETY
Company limited by guarantee, registered in England no.2988368 Registered charity no. 1042574

The International Classification of Headache Disorders
2nd Edition (1st revision) (ICHD-IIR1)
Abbreviated pocket version
for reference by professional users only, prepared by the Headache Classification Subcommittee of the International Headache Society

Jes Olesen (Chairman), Marie-Germaine Bousser, Hans-Christoph Diener, David Dodick, Michael First, Peter J Goadsby, Hartmut Göbel, Miguel JA Lainez, James W Lance, Richard B Lipton, Giuseppe Nappi, Fumihiko Sakai, Jean Schoenen, Stephen D Silberstein, Timothy J Steiner.

International Headache Society 2004/5

2 Introduction to Abbreviated Pocket Version
The International Classification of Headache Disorders, 2 nd edition, is published by International Headache Society (Cephalalgia 2004; 24 (suppl 1): 1-160, revised Cephalalgia 2005; 25: 460-465) and is accessible at www.i-h-s.org. This abbreviated version, including the most common or important headache disorders, is an aide memoire for those familiar with the classification principles and experienced in their application. It lists the diagnostic criteria but omits explanatory introductions, descriptions, notes and comments which in many cases are key to proper and accurate usage.

Classification
ICHD-II ICD-10NA Diagnosis [aetiological ICD-10 code code code for secondary headaches] 1. 1.1 1.2 1.2.1 1.2.2 1.2.3 1.2.4 1.2.5 1.2.6 1.3 1.3.1 1.3.2 1.3.3 1.4 1.5 1.5.1 1.5.2 1.5.3 1.5.4 1.5.5 1.6 1.6.1 1.6.2 1.6.5 G43 G43.0 G43.1 G43.10 G43.10 G43.104 G43.105 G43.105 G43.103 G43.82 G43.82 G43.820 G43.821 G43.81 G43.3 G43.3 G43.2 G43.3 G43.3 G43.3 G43.83 G43.83 G43.83 G43.83 Migraine Migraine without aura Migraine with aura Typical aura with migraine headache Typical aura with non-migraine headache Typical aura without headache Familial hemiplegic migraine Sporadic hemiplegic migraine Basilar-type migraine Childhood periodic syndromes that are commonly precursors of migraine Cyclical vomiting Abdominal migraine Benign paroxysmal vertigo of childhood Retinal migraine Complications of migraine Chronic migraine Status migrainosus Persistent aura without infarction Migrainous infarction Migraine-triggered seizures [+ G40.x or G41.x to specify the type of seizure] Probable migraine Probable migraine without aura Probable migraine with aura Probable chronic migraine

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2. 2.1 2.1.1 2.1.2 2.2 2.2.1 2.2.2 2.3 2.3.1 2.3.2 2.4 2.4.1 2.4.2 2.4.3 3. 3.1 3.1.1 3.1.2 3.2 3.2.1 3.2.2 3.3 3.4 3.4.1 3.4.2 3.4.3 4. 4.1 4.2 4.3 4.4 4.4.1 4.4.2 4.5 4.6 4.7 G44.2 G44.2 G44.20 G44.21 G44.2 G44.20 G44.21 G44.2 G44.22 G44.23 G44.28 G44.28 G44.28 G44.28 G44.0 G44.0 G44.01 G44.02 G44.03 G44.03 G44.03 G44.08 G44.08 G44.08 G44.08 G44.08 G44.80 G44.800 G44.803 G44.804 G44.805 G44.805 G44.805 G44.80 G44.80 G44.80 Tension-type headache (TTH) Infrequent episodic TTH Infrequent episodic TTH associated with pericranial tenderness Infrequent episodic TTH not associated with pericranial tenderness Frequent episodic TTH Frequent episodic TTH associated with pericranial tenderness Frequent episodic TTH not associated with pericranial tenderness Chronic TTH Chronic TTH associated with pericranial tenderness Chronic TTH not associated with pericranial tenderness Probable TTH Probable infrequent episodic TTH Probable frequent episodic TTH Probable chronic TTH Cluster headache and other trigeminal autonomic cephalalgias (TAC) Cluster headache Episodic cluster headache Chronic cluster headache Paroxysmal hemicrania Episodic paroxysmal hemicrania Chronic paroxysmal hemicrania Short-lasting unilateral neuralgiform headache attacks with con-junctival injection and tearing (SUNCT) Probable TAC Probable cluster headache Probable paroxysmal hemicrania Probable SUNCT Other primary headaches Primary stabbing headache Primary cough headache Primary exertional headache Primary headache associated with sexual activity Preorgasmic headache Orgasmic headache Hypnic headache Primary thunderclap headache Hemicrania continua

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4.8 5. 5.1 5.1.1 5.1.2 5.2 5.2.1 5.2.2 5.3 5.4 5.5 5.5.1 5.5.2 5.6 5.6.1 5.6.2 5.7 5.7.1 5.7.2 6. 6.1 6.1.1 6.1.2 6.2 6.2.1 6.2.2 G44.2 G44.88 G44.880 G44.880 G44.880 G44.3 G44.30 G44.31 G44.841 G44.841 G44.88 G44.88 G44.88 G44.88 G44.88 G44.88 G44.88 G44.880 G44.30 G44.81 G44.810 G44.810 G44.810 G44.810 G44.810 G44.810 New daily-persistent headache Headache attributed to head and/or neck trauma Acute post-traumatic headache Acute post-traumatic headache attributed to moderate or severe head injury [S06] Acute post-traumatic headache attributed to mild head injury [S09.9] Chronic post-traumatic headache Chronic post-traumatic headache attributed to moderate or severe head injury [S06] Chronic post-traumatic headache attributed to mild head injury [S09.9] Acute headache attributed to whiplash injury [S13.4] Chronic headache attributed to whiplash injury [S13.4] Headache attributed to traumatic intracranial haematoma Headache attributed to epidural haematoma [S06.4] Headache attributed to subdural haematoma [S06.5] Headache attributed to other head and/or neck trauma [S06] Acute headache attributed to other head/neck trauma [S06] Chronic headache attributed to other head/neck trauma [S06] Post-craniotomy headache Acute post-craniotomy headache Chronic post-craniotomy headache Headache attributed to cranial or cervical vascular disorder Headache attributed to ischaemic stroke or TIA Headache attributed to ischaemic stroke [I63] Headache attributed to TIA [G45] Headache attributed to nontraumatic intracranial haemorrhage [I62] Headache attributed to intracerebral haemorrhage [I61] Headache attributed to subarachnoid haemorrhage [I60]

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6.3 6.3.1 6.3.2 6.3.3 6.3.4 6.3.5 G44.811 G44.811 G44.811 G44.811 G44.811 G44.811 Headache attributed to unruptured vascular malformation [Q28] Headache attributed to saccular aneurysm [Q28.3] Headache attributed to arteriovenous malformation [Q28.2] Headache attributed to dural arteriovenous fistula [I67.1] Headache attributed to cavernous angioma [D18.0] Headache attributed to encephalotrigeminal or leptomeningeal angiomatosis (Sturge Weber syndrome) [Q85.8] Headache attributed to arteritis [M31] Headache attributed to giant cell arteritis [M31.6] Headache attributed to primary CNS angiitis [I67.7] Headache attributed to secondary CNS angiitis [I68.2] Carotid or vertebral artery pain [I63.0, I63.2, I65.0, I65.2 or I67.0] Headache or facial or neck pain attributed to arterial dissection [I67.0] Post-endarterectomy headache [I97.8] Carotid angioplasty headache Headache attributed to intracranial endovascular procedures Angiography headache Headache attributed to cerebral venous thrombosis [I63.6] Headache attributed to other intracranial vascular disorder Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) [I67.8] Mitochondrial encephalopathy, lactic acidosis and stroke-like episodes (MELAS) [G31.81] Headache attributed to benign angiopathy of the CNS [I99] Headache attributed to pituitary apoplexy [E23.6] Headache attributed to nonvascular intracranial disorder Headache attributed to high cerebrospinal fluid (CSF) pressure

6.4 6.4.1 6.4.2 6.4.3 6.5 6.5.1 6.5.2 6.5.3 6.5.4 6.5.5 6.6 6.7 6.7.1

G44.812 G44.812 G44.812 G44.812 G44.810 G44.810 G44.814 G44.810 G44.810 G44.810 G44.810 G44.81 G44.81

6.7.2 6.7.3 6.7.4 7. 7.1

G44.81 G44.81 G44.81 G44.82 G44.820

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7.1.1 7.1.2 7.1.3 7.2 7.2.1 7.2.2 7.2.3 7.3 7.3.1 7.3.2 7.3.3 7.3.4 7.4 7.4.1 G44.820 G44.820 G44.820 G44.820 G44.820 G44.820 G44.820 G44.82 G44.823 G44.823 G44.823 G44.82 G44.822 G44.822 Headache attributed to idiopathic intracranial hypertension [G93.2] Headache attributed to intracranial hypertension secondary to metabolic/toxic/hormonal causes Headache attributed to intracranial hypertension secondary to hydrocephalus [G91.8] Headache attributed to low cerebrospinal fluid (CSF) pressure Post-dural puncture headache [G97.0] CSF fistula headache [G96.0] Headache attributed to spontaneous (or idiopathic) low CSF pressure Headache attributed to noninfectious inflammatory disease Headache attributed to neurosarcoidosis [D86.8] Headache attributed to aseptic (non-infectious) meningitis [code for aetiology] Headache attributed to other noninfectious inflammatory disease [code for aetiology] Headache attributed to lymphocytic hypophysitis [E23.6] Headache attributed to intracranial neoplasm [C00-D48] Headache attributed to increased intracranial pressure or hydrocephalus caused by neoplasm [code for neoplasm] Headache attributed directly to neoplasm [code for neoplasm] Headache attributed to carcinomatous meningitis [C79.3] Headache attributed to hypothalamic or pituitary hyperor hyposecretion [E23.0] Headache attributed to intrathecal injection [G97.8] Headache attributed to epileptic seizure [G40.x or G41.x] Hemicrania epileptica [G40.x or G41.x] Post-seizure headache [G40.x or G41.x] Headache attributed to Chiari malformation type I [Q07.0] Syndrome of transient headache and neurological deficits with CSF lymphocytosis (HaNDL)

7.4.2 7.4.3 7.4.4 7.5 7.6 7.6.1 7.6.2 7.7 7.8

G44.822 G44.822 G44.822 G44.824 G44.82 G44.82 G44.82 G44.82 G44.82

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7.9 8. 8.1 8.1.1 8.1.1.1 8.1.1.2 8.1.2 8.1.3 8.1.4 8.1.4.1 8.1.4.2 8.1.5 8.1.5.1 8.1.6 8.1.7 8.1.8 8.1.8.1 8.1.8.2 8.1.9 8.1.9.1 8.1.9.2 8.1.10 G44.82 G44.4 or G44.83 G44.40 G44.400 G44.400 G44.400 G44.40 G44.402 G44.83 G44.83 G44.83 G44.4 G44.401 G44.83 G44.83 G44.40 G44.40 G44.40 G44.40 G44.40 G44.40 G44.41 Headache attributed to other nonvascular intracranial disorder Headache attributed to a substance or its withdrawal Headache induced by acute substance use or exposure Nitric oxide (NO) donor-induced headache [X44] Immediate NO donor-induced headache [X44] Delayed NO donor-induced headache [X44] Phosphodiesterase inhibitorinduced headache [X44] Carbon monoxide (CO)-induced headache [X47] Alcohol-induced headache [F10] Immediate alcohol-induced headache [F10] Delayed alcohol-induced headache [F10] Headache induced by food components and additives Monosodium glutamate-induced headache [X44] Cocaine-induced headache [F14] Cannabis-induced headache [F12] Histamine-induced headache [X44] Immediate histamine-induced headache [X44] Delayed histamine-induced headache [X44] Calcitonin gene-related peptide (CGRP)-induced headache [X44] Immediate CGRP-induced headache [X44] Delayed CGRP-induced headache [X44] Headache as an acute adverse event attributed to medication used for other indications [code for substance] Headache attributed to other acute substance use or exposure [code for substance] Medication-overuse headache (MOH) Ergotamine-overuse headache [Y52.5] Triptan-overuse headache

8.1.11 8.2 8.2.1 8.2.2

G44.4 or G44.83 G44.41 or G44.83 G44.411 G44.41

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8.2.3 8.2.4 8.2.5 8.2.6 8.2.7 8.2.8 8.3 8.3.1 8.4 8.4.1 8.4.2 8.4.3 8.4.4 G44.410 G44.83 G44.410 G44.41  G44.83 G44.410 G44.41 or G44.83 G44.4 G44.418 G44.83 G44.83 G44.83 G44.83 G44.83 Analgesic-overuse headache [F55.2] Opioid-overuse headache [F11.2] Combination analgesic-overuse headache [F55.2] MOH attributed to combination of acute medications Headache attributed to other medication overuse [code for substance] Probable MOH [code for substance] Headache as an adverse event attributed to chronic medication [code for substance] Exogenous hormone-induced headache [Y42.4] Headache attributed to substance withdrawal Caffeine-withdrawal headache [F15.3] Opioid-withdrawal headache [F11.3] Oestrogen-withdrawal headache [Y42.4] Headache attributed to withdrawal from chronic use of other substances [code for substance] Headache attributed to infection Headache attributed to intracranial infection [G00-G09] Headache attributed to bacterial meningitis [G00.9] Headache attributed to lymphocytic meningitis [G03.9] Headache attributed to encephalitis [G04.9] Headache attributed to brain abscess [G06.0] Headache attributed to subdural empyema [G06.2] Headache attributed to systemic infection [A00-B97] Headache attributed to systemic bacterial infection [code for aetiology] Headache attributed to systemic viral infection [code for aetiology] Headache attributed to other systemic infection [code for aetiology]

9. 9.1 9.1.1 9.1.2 9.1.3 9.1.4 9.1.5 9.2 9.2.1 9.2.2 9.2.3

G44.821 G44.821 G44.821 G44.821 G44.821 G44.821 G44.881 G44.881 G44.881 G44.881

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9.3 9.4 9.4.1 10. 10.1 10.1.1 10.1.2 10.1.3 10.2 10.3 10.3.1 10.3.2 10.3.3 10.3.4 10.3.5 10.3.6 10.4 10.5 10.6 10.7 G44.821 Headache attributed to HIV/AIDS [B22] G44.821 or Chronic post-infection headache G44.881 [code for aetiology] G44.821 Chronic post-bacterial meningitis headache [G00.9] Headache attributed to disorder G44.882 of homoeostasis Headache attributed to hypoxia G44.882 and/or hypercapnia High-altitude headache [W94] G44.882 Diving headache G44.882 Sleep apnoea headache [G47.3] G44.882 Dialysis headache [Y84.1] G44.882 Headache attributed to arterial G44.813 hypertension [I10] Headache attributed to phaeoG44.813 chromocytoma [D35.0 (benign) or C74.1 (malignant)] Headache attributed to hypertenG44.813 sive crisis without hypertensive encephalopathy [I10] Headache attributed to hypertenG44.813 sive encephalopathy [I67.4] Headache attributed to preG44.813 eclampsia [O13-O14] Headache attributed to eclampsia G44.813 [O15] Headache attributed to acute G44.813 pressor response to an exogenous agent [code for aetiology] Headache attributed to hypothyG44.882 roidism [E03.9] Headache attributed to fasting G44.882 [T73.0] Cardiac cephalalgia [code for G44.882 aetiology] Headache attributed to other G44.882 disorder of homoeostasis [code for aetiology] Headache or facial pain attribuG44.84 ted to disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cranial structures Headache attributed to disorder of G44.840 cranial bone [M80-M89.8] Headache attributed to disorder of G44.841 neck [M99] Cervicogenic headache [M99] G44.841

11.

11.1 11.2 11.2.1

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11.2.2 11.2.3 11.3 11.3.1 11.3.2 11.3.3 11.3.4 11.4 11.5 11.6 11.7 11.8 Headache attributed to retropharyngeal tendonitis [M79.8] Headache attributed to cranioG44.841 cervical dystonia [G24] Headache attributed to disorder of G44.843 eyes Headache attributed to acute G44.843 glaucoma [H40] Headache attributed to refractive G44.843 errors [H52] Headache attributed to heteroG44.843 phoria or heterotropia (manifest or latent squint) [H50.3-H50.5] Headache attributed to ocular G44.843 inflammatory disorder [code for aetiology] Headache attributed to disorder of G44.844 ears [H60-H95] Headache attributed to rhinoG44.845 sinusitis [J01] Headache attributed to disorder of G44.846 teeth, jaws or related structures [K00-K14] Headache or facial pain attributed G44.846 to temporomandibular joint (TMJ) disorder [K07.6] Headache attributed to other G44.84 disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cervical structures [code for aetiology] Headache attributed to R51 psychiatric disorder Headache attributed to somatisation R51 disorder [F45.0] Headache attributed to psychotic R51 disorder [code for aetiology] G44.847, Cranial neuralgias and central G44.848 or causes of facial pain G44.85 Trigeminal neuralgia G44.847 Classical trigeminal neuralgia G44.847 [G50.00] Symptomatic trigeminal neuralgia G44.847 [G53.80 + code for aetiology] Glossopharyngeal neuralgia G44.847 Classical glossopharyngeal G44.847 neuralgia [G52.10] Symptomatic glossopharyngeal G44.847 neuralgia [G53.830 + code for aetiology] G44.842

12. 12.1 12.2 13. 13.1 13.1.1 13.1.2 13.2 13.2.1 13.2.2

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Nervus intermedius neuralgia [G51.80] Superior laryngeal neuralgia 13.4 G44.847 [G52.20] Nasociliary neuralgia [G52.80] 13.5 G44.847 Supraorbital neuralgia [G52.80] 13.6 G44.847 Other terminal branch neuralgias 13.7 G44.847 [G52.80] Occipital neuralgia [G52.80] 13.8 G44.847 Neck-tongue syndrome 13.9 G44.851 External compression headache 13.10 G44.801 Cold-stimulus headache 13.11 G44.802 Headache attributed to external 13.11.1 G44.8020 application of a cold stimulus Headache attributed to ingestion 13.11.2 G44.8021 or inhalation of a cold stimulus Constant pain caused by compres13.12 G44.848 sion, irritation or distortion of cranial nerves or upper cervical roots by structural lesions [G53.8 + code for aetiology] Optic neuritis [H46] 13.13 G44.848 Ocular diabetic neuropathy 13.14 G44.848 [E10-E14] G44.881 or Head or facial pain attributed to 13.15 G44.847 herpes zoster Head or facial pain attributed to 13.15.1 G44.881 acute herpes zoster [B02.2] Post-herpetic neuralgia [B02.2] 13.15.2 G44.847 Tolosa-Hunt syndrome 13.16 G44.850 Ophthalmoplegic “migraine” 13.17 G43.80 G44.810 or Central causes of facial pain 13.18 G44.847 Anaesthesia dolorosa [G52.800 + 13.18.1 G44.847 code for aetiology] Central post-stroke pain [G46.21] 13.18.2 G44.810 Facial pain attributed to multiple 13.18.3 G44.847 sclerosis [G35] Persistent idiopathic facial pain 13.18.4 G44.847 [G50.1] Burning mouth syndrome [code 13.18.5 G44.847 for aetiology] Other cranial neuralgia or other 13.19 G44.847 centrally mediated facial pain [code for aetiology] Other headache, cranial 14. R51 neuralgia, central or primary facial pain 14.1 R51 Headache not elsewhere classified 14.2 R51 Headache unspecified 13.3 G44.847

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PART 1. THE PRIMARY HEADACHES

1. [G43] Migraine
1.1 [G43.0] Migraine without aura A. At least 5 attacks fulfilling criteria B–D B. Headache attacks lasting 4-72 hours (untreated or unsuccessfully treated) C. Headache has at least 2 of the following characteristics: 1. unilateral location 2. pulsating quality 3. moderate or severe pain intensity 4. aggravation by or causing avoidance of routine physical activity (eg, walking or climbing stairs) D. During headache at least 1 of the following: 1. nausea and/or vomiting 2. photophobia and phonophobia E. Not attributed to another disorder 1.2 [G43.1] Migraine with aura A. At least 2 attacks fulfilling criterion B B. Migraine aura fulfilling criteria B–C for one of the subforms 1.2.1-1.2.6 C. Not attributed to another disorder 1.2.1 [G43.10] Typical aura with migraine headache A. At least 2 attacks fulfilling criteria B–D B. Aura consisting of at least 1 of the following, but no motor weakness: 1. fully reversible visual symptoms including positive features (eg, flickering lights, spots or lines) and/or negative features (ie, loss of vision) 2. fully reversible sensory symptoms including positive features (ie, pins and needles) and/or negative features (ie, numbness) 3. fully reversible dysphasic speech disturbance C. At least two of the following: 1. homonymous visual symptoms and/or unilateral sensory symptoms 2. at least one aura symptom develops gradually over 5 minutes and/or different aura symptoms occur in succession over 5 minutes 3. each symptom lasts 5 and 60 minutes D. Headache fulfilling criteria B–D for 1.1 Migraine without aura begins during the aura or follows aura within 60 minutes E. Not attributed to another disorder

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1.2.3 [G43.104] Typical aura without headache As 1.2.1 except: B. Aura consisting of at least 1 of the following, with or without speech disturbance but no motor weakness: 1. fully reversible visual symptoms including positive features (eg, flickering lights, spots or lines) and/or negative features (ie, loss of vision) 2. fully reversible sensory symptoms including positive features (ie, pins and needles) and/or negative features (ie, numbness) D. Headache does not occur during aura nor follow aura within 60 minutes

2. [G44.2] Tension-type headache (TTH)
2.1 [G44.2] Infrequent episodic tension-type headache A. At least 10 episodes occurring on <1 day/month on average (<12 days/year) and fulfilling criteria B–D B. Headache lasting from 30 minutes to 7 days C. Headache has at least 2 of the following characteristics: 1. bilateral location 2. pressing/tightening (non-pulsating) quality 3. mild or moderate intensity 4. not aggravated by routine physical activity such as walking or climbing stairs D. Both of the following: 1. no nausea or vomiting (anorexia may occur) 2. no more than one of photophobia or phonophobia E. Not attributed to another disorder 2.2 [G44.2] Frequent episodic tension-type headache As 2.1 except: A. At least 10 episodes occurring on 1 but <15 days/month for ≥3 months (12 and <180 days/year) and fulfilling criteria B–D 2.3 [G44.2] Chronic tension-type headache As 2.1 except: A. Headache occurring on 15 days/month on average for >3 months (180 days/year) and fulfilling criteria B–D B. Headache lasts hours or may be continuous D. Both of the following: 1. no more than one of photophobia, phonophobia or mild nausea 2. neither moderate or severe nausea nor vomiting

14 3. [G44.0] Cluster headache and other trigeminal autonomic cephalalgias
3.1 [G44.0] Cluster headache A. At least 5 attacks fulfilling criteria B–D B. Severe or very severe unilateral orbital, supraorbital and/or temporal pain lasting 15-180 minutes if untreated C. Headache is accompanied by at least 1 of the following: 1. ipsilateral conjunctival injection and/or lacrimation 2. ipsilateral nasal congestion and/or rhinorrhoea 3. ipsilateral eyelid oedema 4. ipsilateral forehead and facial sweating 5. ipsilateral miosis and/or ptosis 6. a sense of restlessness or agitation D. Attacks have a frequency from 1 every other day to 8/day E. Not attributed to another disorder 3.1.1 [G44.01] Episodic cluster headache A. Attacks fulfilling criteria A–E for 3.1 Cluster headache B. At least two cluster periods lasting 7-365 days and separated by pain-free remission periods of 1 month 3.1.2 [G44.02] Chronic cluster headache A. Attacks fulfilling criteria A–E for 3.1 Cluster headache B. Attacks recur over >1 year without remission periods or with remission periods lasting <1 month

PART 2. THE SECONDARY HEADACHES A de novo headache occurring with another disorder recognised to be capable of causing it is diagnosed as secondary. A patient who has previously had a primary headache that becomes worse in close temporal relation to the occurrence of another disorder can receive two diagnoses: the primary headache diagnosis and the secondary headache diagnosis. The following factors support the use of two diagnoses: a very close temporal relation, marked worsening of the primary headache, the existence of other evidence that the other disorder can aggravate primary headache in the manner observed, and remission of the headache after cure or remission of the other disorder.

15 5. [G44.88] Headache attributed to head and/or neck trauma
5.2.1 [G44.30] Chronic post-traumatic headache attributed to moderate or severe head injury [S06] A. Headache, no typical characteristics known, fulfilling criteria C–D B. Head trauma with at least 1 of the following: 1. loss of consciousness for >30 minutes 2. Glasgow Coma Scale (GCS) <13 3. post-traumatic amnesia for >48 hours 4. imaging demonstration of a traumatic brain lesion (cerebral haematoma, intracerebral/subarachnoid haemorrhage, brain contusion, skull fracture) C. Headache develops within 7 days after head trauma or after regaining consciousness following head trauma D. Headache persists for >3 months after head trauma

6. [G44.81] Headache attributed to cranial or cervical vascular disorder
6.4.1 [G44.812] Headache attributed to giant cell arteritis (GCA) [M31.6] A. Any new persisting headache fulfilling criteria C–D B. At least one of the following: 1. swollen tender scalp artery with elevated erythrocyte sedimentation rate and/or C reactive protein 2. temporal artery biopsy demonstrating giant cell arteritis C. Headache develops in close temporal relation to other symptoms and signs of giant cell arteritis D. Headache resolves or greatly improves within 3 days of high-dose steroid treatment

7. [G44.82] Headache attributed to non-vascular intracranial disorder
7.1.1 [G44.820] Headache attributed to idiopathic intracranial hypertension (IIH) [G93.2] A. Progressive headache with at least 1 of the following characteristics and fulfilling criteria C–D: 1. daily occurrence 2. diffuse and/or constant (non-pulsating) pain 3. aggravated by coughing or straining B. Intracranial hypertension fulfilling the following criteria: 1. alert patient with neurological examination that either is normal or demonstrates any of the

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following abnormalities: a) papilloedema b) enlarged blind spot c) visual field defect (progressive if untreated) d) sixth nerve palsy 2. increased CSF pressure (>200 mm H2O in the nonobese, >250 mm H2O in the obese) measured by lumbar puncture in the recumbent position or by epidural or intraventricular pressure monitoring 3. normal CSF chemistry (low CSF protein is acceptable) and cellularity 4. intracranial diseases (including venous sinus thrombosis) ruled out by appropriate investigations 5. no metabolic, toxic or hormonal cause of intracranial hypertension Headache develops in close temporal relation to increased intracranial pressure Headache improves after withdrawal of CSF to reduce pressure to 120-170 mm H2O and resolves within 72 hours of persistent normalisation of intracranial pressure

C. D.

7.4.1 [G44.822] Headache attributed to increased intracranial pressure or hydrocephalus caused by neoplasm [C00-D48] A. Diffuse non-pulsating headache with at least 1 of the following characteristics and fulfilling criteria C–D: 1. associated with nausea and/or vomiting 2. worsened by physical activity and/or manoeuvres known to increase intracranial pressure (such as Valsalva manoeuvre, coughing or sneezing) 3. occurring in attack-like episodes B. Space-occupying intracranial tumour* demonstrated by CT or MRI and causing hydrocephalus C. Headache develops and/or deteriorates in close temporal relation to the hydrocephalus D. Headache improves within 7 days after surgical removal or volume-reduction of tumour *including colloid cyst of the IIIrd ventricle. 7.4.2 [G44.822] Headache attributed directly to neoplasm [C00-D48] A. Headache with at least 1 of the following characteristics and fulfilling criteria C–D: 1. progressive 2. localised 3. worse in the morning 4. aggravated by coughing or bending forward

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B. C. D. Intracranial neoplasm shown by imaging Headache develops in temporal (and usually spatial) relation to the neoplasm Headache resolves within 7 days after surgical removal or volume-reduction of neoplasm or treatment with corticosteroids

8. [G44.4 or G44.83] Headache attributed to a substance or its withdrawal
8.1.3 [G44.402] Carbon monoxide (CO)-induced headache [X47] A. Bilateral and/or continuous headache, with quality and intensity that may be related to the severity of CO intoxication, fulfilling criteria C–D B. Exposure to carbon monoxide (CO) C. Headache develops within 12 hours of exposure D. Headache resolves within 72 hours after elimination of CO 8.2 [G44.41 or G44.83] Medication-overuse headache† A. Headache present on ≥15 days/month fulfilling criteria C and D B. Regular overuse for >3 months of one or more drugs that can be taken for acute and/or symptomatic treatment of headache C. Headache has developed or markedly worsened during medication overuse D. Headache resolves or reverts to its previous pattern within 2 months after discontinuation of overused medication 8.2.1 [G44.411] Ergotamine-overuse headache [Y52.5] A. Headache fulfilling criteria A, C and D for 8.2 Medication-overuse headache B. Ergotamine intake on 10 days/month on a regular basis for >3 months 8.2.2 [G44.41] Triptan-overuse headache A. Headache fulfilling criteria A, C and D for 8.2 Medication-overuse headache B. Triptan intake (any formulation) on 10 days/month on a regular basis for >3 months
†

The changes to ICHD-II in this first revision are confined to this group of disorders. 8.2.6 MOH attributed to combination of acute medications is newly described.

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8.2.3 [G44.410] Analgesic-overuse headache [F55.2] A. Headache fulfilling criteria A, C and D for 8.2 Medication-overuse headache B. Intake of simple analgesics on 15 days/month on a regular basis for >3 months 8.2.4 [G44.83] Opioid-overuse headache [F11.2] A. Headache fulfilling criteria A, C and D for 8.2 Medication-overuse headache B. Opioid intake on 10 days/month on a regular basis for >3 months 8.2.5 [G44.410] Combination analgesic-overuse headache [F55.2] A. Headache fulfilling criteria A, C and D for 8.2 Medication-overuse headache B. Intake of combination analgesic medications on 10 days/month on a regular basis for >3 months 8.2.6 [G44.41  G44.83] MOH attributed to combination of acute medications A. Headache fulfilling criteria A, C and D for 8.2 Medication-overuse headache B. Intake of any combination of ergotamine, triptans, analgesics and/or opioids on 10 days/month on a regular basis for >3 months without overuse of any single class alone 8.2.7 [G44.410] Headache attributed to other medicationoveruse A. Headache fulfilling criteria A, C and D for 8.2 Medication-overuse headache B. Regular overuse for >3 months of a medication other than those described above 8.2.8 [G44.41 or G44.83] Probable medication-overuse headache* A. Headache fulfilling criteria A and C for 8.2 Medicationoveruse headache B. Medication-overuse fulfilling criterion B for any one of the subforms 8.2.1-8.2.7 C. One or other of the following: 1. overused medication has not yet been withdrawn 2. medication overuse has ceased within the last 2 months but headache has not so far resolved or reverted to its previous pattern

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8.4 [G44.83] Headache attributed to substance withdrawal 8.4.3 [G44.83] Oestrogen-withdrawal headache [Y42.4] A. Headache or migraine fulfilling criteria C–D B. Daily use of exogenous oestrogen for 3 weeks, which is interrupted C. Headache or migraine develops within 5 days after last use of oestrogen D. Headache or migraine resolves within 3 days

11. [G44.84] Headache or facial pain attributed to disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cranial structures
11.2.1 [G44.841] Cervicogenic headache [M99] A. Pain, referred from a source in the neck and perceived in one or more regions of the head and/or face, fulfilling criteria C–D B. Clinical, laboratory and/or imaging evidence of a disorder or lesion within the cervical spine or soft tissues of the neck known to be, or generally accepted as, a valid cause of headache C. Evidence that the pain can be attributed to the neck disorder or lesion based on at least 1 of the following: 1. demonstration of clinical signs that implicate a source of pain in the neck 2. abolition of headache following diagnostic blockade of a cervical structure or its nerve supply using placebo- or other adequate controls D. Pain resolves within 3 months after successful treatment of the causative disorder or lesion

PART 3. CRANIAL NEURALGIAS, CENTRAL AND PRIMARY FACIAL PAIN AND OTHER HEADACHES

13. [G44.847, G44.848 or G44.85] Cranial neuralgias and central causes of facial pain
13.1.1 [G44.847] Classical trigeminal neuralgia [G50.00] A. Paroxysmal attacks of pain lasting from a fraction of a second to 2 minutes, affecting one or more divisions of the trigeminal nerve and fulfilling criteria B–C B. Pain has at least 1 of the following characteristics: 1. intense, sharp, superficial or stabbing 2. precipitated from trigger areas or by trigger factors

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C. D. E. Attacks are stereotyped in the individual patient There is no clinically evident neurological deficit Not attributed to another disorder

13.8 [G44.847] Occipital neuralgia [G52.80] A. Paroxysmal stabbing pain, with or without persistent aching between paroxysms, in the distribution(s) of the greater, lesser and/or third occipital nerves B. Tenderness over the affected nerve C. Pain is eased temporarily by local anaesthetic block of the nerve 13.18 [G44.810 or G44.847] Central causes of facial pain 13.18.4 [G44.847] Persistent idiopathic facial pain [G50.1] A. B. C. D. Pain in the face, present daily and persisting for all or most of the day, fulfilling criteria B–C Pain is confined at onset to a limited area on one side of the face, and is deep and poorly localised Pain is not associated with sensory loss or other physical signs Investigations including X-ray of face and jaws do not demonstrate any relevant abnormality


								
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